Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Sharifi, Iraj; Khosravi, Ahmad; Aflatoonian, Mohammad Reza; Salarkia, Ehsan; Bamorovat, Mehdi; Karamoozian, Ali; Moghadam, Mahmood Nekoei; Sharifi, Farshad; Afshar, Abbas Aghaei; Afshari, Setareh Agha Kuchak; Gharachorloo, Faranak; Shirzadi, Mohammad Reza; Amiri, Behzad; Zainali, Mohammad; Doosti, Sara; Zamani, Omid; Gouya, MM

doi:10.3389/fpubh.2023.1091709

Cited by 7 publications

(10 citation statements)

References 124 publications

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“…The research also shows the distribution and average incidence rate (2013–2020) of zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major and anthroponotic cutaneous leishmaniasis (ACL) caused by L. tropica across different provinces in Iran. These findings indicate that infections with both types of cutaneous leishmaniasis have been identified in most provinces of Iran (26,104).…”

Section: Discussionsupporting

confidence: 53%

“…In regions with lower ZCL, sporadic cases often occur in travelers returning from endemic areas or imported cases from animal populations. ZCL is a significant public health problem in North Africa, the Middle East and parts of Central/South Asia, with Iran being one of the most severely affected countries (16,(26)(27). In 2015, the World Health Organization (WHO) reported on the incidence of zoonotic cutaneous leishmaniasis (ZCL) in North Africa and West Asia and on the incidence of cutaneous leishmaniasis in North Africa and the Middle East.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

jamali,

Bokaie

2024

Preprint

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Introduction and objectives: Zoonotic cutaneous leishmaniasis (ZCL) remains a significant health problem, particularly in Iran, where 15.8 cases per 100,000 people were reported in 2019. Iran accounted for more than half of all new cases in the Eastern Mediterranean region in 2008. entified several countries in the Middle East and North Africa, including Syria, Afghanistan, Iran, Pakistan, Iraq, Yemen, Tunisia, Morocco, Libya and Egypt, as having the highest rates of this disease, which is a major burden in the rural areas of these regions. ZCL is a major global health problem, especially in countries such as Iran, the Middle East and North Africa.ZCL is a major global health problem, particularly in countries such as Iran, the Middle East and North Africa. Despite the existing research on cutaneous leishmaniasis, few studies focus exclusively on the epidemiologic aspects of ZCL. This systematic study aims to fill this gap by investigating the geographical distribution and cause of occurrence and identifying reservoirs, vectors and sites of ZCL occurrence, focusing on high-risk areas such as Algeria and Tunisia in North Africa in figure 8. Areas suitable for vector-borne transmission and ZCL reservoirs are expected to increase in the future. Understanding the ecological links between vectors, reservoirs and the Leishmania parasite is crucial for the development of effective control and prevention strategies. It is expected that the regions favorable for vector-borne transmission and the reservoirs of zoonotic cutaneous leishmaniasis (ZCL) will expand as environmental conditions evolve. To develop effective control and prevention strategies, it is important to understand the ecological interplay between vectors, reservoirs and the leishmaniasis parasite. Climate change is expected to exacerbate the threat of ZCL by 2050, potentially increasing the suitability of habitats for vectors and reservoirs. This study uniquely examines the epidemiologic aspects of ZCL globally, filling a gap in the current literature that predominantly addresses cutaneous leishmaniasis in a broader context. Results: This study provides a detailed insight into the increasing prevalence of zoonotic cutaneous leishmaniasis (ZCL) in Iran. It identifies Iran, where 18 out of 31 provinces are affected, as a critical area, especially the central provinces. Key factors such as Leishmania reservoirs in rodents, emerging reservoirs, and specific vectors contribute significantly to the transmission of the disease and are influenced by environmental and climatic conditions in Iran, the Middle East, and North Africa. The study highlights new hotspots in Iran, such as Beyza district in Fars province and regions in Isfahan and Razavi Khorasan provinces, which indicate the dynamic nature of the spread of ZCL associated with urbanization and climate change. Predictive modeling suggests that an increase in ZCL may soon occur in northwestern Iran due to suitable environmental conditions for the vectors and reservoirs. On the other hand, the identification of new reservoirs was an important result. These included different hedgehog species (Paraechinus aethiopicus, Atelerix algirus, and Hemiechinus auritus) in Algeria, Tunisia, and Iran as well as calomyscid rodents in Shiraz, the capital of the Iranian province of Fars. Interestingly, specific vectors and reservoirs make Tunisia and Algeria high-risk areas in North Africa, emphasizing the need for regional integrated control measures. The results highlight a crucial gap in the research and control of zoonotic cutaneous leishmaniasis outside Iran. In the last ten years, the focus has been less on the Middle East and Central Asia, although the disease is widespread in these regions. Conclusion: This review emphasizes the critical need for a combined approach to the control and prevention of zoonotic cutaneous leishmaniasis (ZCL). This study emphasizes the role of climate change and urban expansion in influencing disease dynamics. The identification of new endemic areas and prediction of future hotspots in Iran will provide valuable insights for targeting prevention and control measures. This underlines the importance of regional collaboration and adaptive strategies in the Middle East and North Africa (MENA) countries to effectively tackle this neglected tropical disease as part of the One Health approach. As the first comprehensive study on the epidemiology of ZCL, this study fills a significant gap in the literature and provides a foundation for future research and public health interventions to mitigate the global impact of ZCL. This systematic review highlights the complicated and multifaceted nature of the disease, which is influenced by various vectors, reservoir hosts, and environmental factors. This comprehensive review not only deepens our understanding of the epidemiology of ZCL, but also provides crucial insights for health managers and policy makers. This knowledge can help them to identify high-risk areas, implement targeted prevention measures, and develop effective control programs to combat this endemic disease. Keywords: Zoonotic cutaneous leishmaniasis, Iran, MiddleEast, Epidemiology, Reservoir, Vector, Systematic Review

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

jamali,

Bokaie

2024

Preprint

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“…The intricate process of host infection is influenced by a subtle interaction among the parasite species, its virulence factors, and the host’s immune response [ 11 ]. Consequently, the prevention of leishmaniasis predominantly centers on the control of vectors and their reservoirs, primarily sandflies, as well as the implementation of appropriate hygiene measures [ 12 ]. However, persistent challenges related to diagnosis and restricted access to healthcare in certain regions continue to impede optimal prevention [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Overview of Research on Leishmaniasis in Africa: Current Status, Diagnosis, Therapeutics, and Recent Advances Using By-Products of the Sargassaceae Family

Abdoul-Latif,

Oumaskour,

Abdallah

et al. 2024

Pharmaceuticals

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Leishmaniasis in Africa, which has been designated as a priority neglected tropical disease by various global organizations, exerts its impact on millions of individuals, primarily concentrated within this particular region of the world. As a result of the progressively grave epidemiological data, numerous governmental sectors and civil organizations have concentrated their endeavors on this widespread outbreak with the objective of devising appropriate remedies. This comprehensive examination delves into multiple facets of this parasitic ailment, scrutinizing the associated perils, diagnostic intricacies, and deficiencies within the existing therapeutic protocols. Despite the established efficacy of current treatments, they are not immune to deleterious incidents, particularly concerning toxicity and the emergence of parasitic resistance, thus accentuating the necessity of exploring alternative avenues. Consequently, this research not only encompasses conventional therapeutic approaches, but also extends its scope to encompass complementary and alternative medicinal techniques, thereby striving to identify innovative solutions. A particularly auspicious dimension of this study lies in the exploration of natural substances and by-products derived from some brown algae of the Sargassaceae family. These resources possess the potential to assume a pivotal role in the management of leishmaniasis.

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“…The leishmaniasis needs assessment is compatible with the despairing necessity for well-organized evidence on the control database worldwide [ 18 ]. We have also abridged significant challenges and crucial requirements for leading an initial control scheme in the direction of the leishmaniasis elimination plan.…”

Section: Introductionmentioning

confidence: 99%

Global Dilemma and Needs Assessment Toward Achieving Sustainable Development Goals in Controlling Leishmaniasis

Bamorovat,

Sharifi,

Khosravi

et al. 2024

J Epidemiol Glob Health

Self Cite

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Leishmaniasis is a disease of poverty that imposes a devastating medical, social, and economic burden on over 1 billion people nationwide. To date, no in-depth study to analyze the major global challenges and needs assessment has been carried out. This investigation aimed to explore a comprehensive narrative review of leishmaniasis’s main challenges and initially highlight obstacles that might impede the implementation of control measures. Also, we propose a specific list of priorities for needs assessment. The presence of socioeconomic factors, multiple clinical and epidemiological forms, various Leishmania species, the complexity of the life cycle, the absence of effective drugs and vaccines, and the lack of efficient vector and reservoir control make this organism unique and sophisticated in playing a tangled role to react tricky with its surrounding environments, despite extensive efforts and implementation of all-inclusive former control measures. These facts indicate that the previous strategic plans, financial support, and basic infrastructures connected to leishmaniasis surveillance are still insufficient. Strengthening the leishmaniasis framework in a context of accelerated programmatic action and intensification of cross-cutting activities along with other neglected tropical diseases (NTDs) is confidently expected to result in greater effectiveness, cost–benefit, and fruitful management. Sensitive diagnostics, effective therapeutics, and efficacious vaccines are vital to accelerating advancement toward elimination, and reducing morbidity/mortality and program costs. Collective actions devoted by all sectors and policy-makers can hopefully overcome technical and operational barriers to guarantee that effective and coordinated implementation plans are sustained to meet the road map for NTDs 2021- 2030 goals.

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Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Cited by 7 publications

References 124 publications

Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

Overview of Research on Leishmaniasis in Africa: Current Status, Diagnosis, Therapeutics, and Recent Advances Using By-Products of the Sargassaceae Family

Global Dilemma and Needs Assessment Toward Achieving Sustainable Development Goals in Controlling Leishmaniasis

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